INTRODUCTION: Traumatic brain injury (TBI) in the elderly is becoming an increasingly frequent phenomenon. Studies have mainly analyzed the influence of age as a continuous variable and have not specifically looked at geriatric patients as a group. The aim of this study is to map the magnitude and characteristics of geriatric TBI and to identify factors contributing to their poorer outcome. MATERIAL AND METHODS: Based on the ICD-9 register of the University Hospitals Leuven demographic and clinical variables of TBI were analyzed (2002-2008). The influence of older age on physiological variables was assessed using the Brain-IT database. RESULTS: The elderly (aged ≥65 years) accounted for 38.2% of non-concussion TBI and 32.6% of ICU admissions, representing the largest age group. The elderly had a significantly lower ICP (median 10.06 mmHg versus median 14.52 mmHg; p = 0.048), but no difference in their measure of autoregulation (daily mABP/ICP correlation coefficient) compared with 20-35 year-olds. TBI was caused by a fall in 78.9% of elderly patients and 42.3% suffered a mass lesion. 72.1% had cardiovascular comorbidity. Complications did not differ from their younger counterparts. DISCUSSION: Geriatric TBI is a significant phenomenon. Poorer outcomes are not yet sufficiently explained by physiological monitoring data, but reduced vascular versatility is likely to contribute. More research is needed in order to develop specific management protocols.
INTRODUCTION:Traumatic brain injury (TBI) in the elderly is becoming an increasingly frequent phenomenon. Studies have mainly analyzed the influence of age as a continuous variable and have not specifically looked at geriatric patients as a group. The aim of this study is to map the magnitude and characteristics of geriatric TBI and to identify factors contributing to their poorer outcome. MATERIAL AND METHODS: Based on the ICD-9 register of the University Hospitals Leuven demographic and clinical variables of TBI were analyzed (2002-2008). The influence of older age on physiological variables was assessed using the Brain-IT database. RESULTS: The elderly (aged ≥65 years) accounted for 38.2% of non-concussion TBI and 32.6% of ICU admissions, representing the largest age group. The elderly had a significantly lower ICP (median 10.06 mmHg versus median 14.52 mmHg; p = 0.048), but no difference in their measure of autoregulation (daily mABP/ICP correlation coefficient) compared with 20-35 year-olds. TBI was caused by a fall in 78.9% of elderly patients and 42.3% suffered a mass lesion. 72.1% had cardiovascular comorbidity. Complications did not differ from their younger counterparts. DISCUSSION: Geriatric TBI is a significant phenomenon. Poorer outcomes are not yet sufficiently explained by physiological monitoring data, but reduced vascular versatility is likely to contribute. More research is needed in order to develop specific management protocols.
Authors: Tony Rosen; Sunday Clark; Elizabeth M Bloemen; Mary R Mulcare; Michael E Stern; Jeffrey E Hall; Neal E Flomenbaum; Mark S Lachs; Soumitra R Eachempati Journal: Injury Date: 2016-09-03 Impact factor: 2.586
Authors: Geert Meyfroidt; Pierre Bouzat; Michael P Casaer; Randall Chesnut; Sophie Rym Hamada; Raimund Helbok; Peter Hutchinson; Andrew I R Maas; Geoffrey Manley; David K Menon; Virginia F J Newcombe; Mauro Oddo; Chiara Robba; Lori Shutter; Martin Smith; Ewout W Steyerberg; Nino Stocchetti; Fabio Silvio Taccone; Lindsay Wilson; Elisa R Zanier; Giuseppe Citerio Journal: Intensive Care Med Date: 2022-05-20 Impact factor: 41.787
Authors: Helena Van Deynse; Wilfried Cools; Bart Depreitere; Ives Hubloue; Carl Ilunga Kazadi; Eva Kimpe; Karen Pien; Griet Van Belleghem; Koen Putman Journal: Front Public Health Date: 2022-08-08